- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT00000693
Suppression of Cytomegalovirus Retinitis Utilizing High Dose Intravenous Acyclovir and Oral Zidovudine in Patients With AIDS
To study the use of acyclovir (ACV) and zidovudine (AZT) in the treatment of cytomegalovirus (CMV) retinitis in patients with AIDS who would otherwise be treated with ganciclovir (DHPG) alone.
CMV retinitis is one of the most common opportunistic infections in patients with AIDS. DHPG is at present the only drug available for widespread compassionate use in the United States. Although most patients respond to treatment with DHPG, the medication does not cure the infection. Most patients will have a relapse and will require retreatment with DHPG. Because of the large relapse rate, most people treated for CMV retinitis are placed on continuous treatment with DHPG. There are two major problems associated with ongoing use of DHPG: 1) The development of a low white blood cell (WBC) count (leukopenia) which is a known side effect of the drug; and 2) the increased risk for leukopenia when DHPG is given together with AZT, the only antiviral drug currently available for the treatment of HIV infection. Therefore, patients cannot take both AZT and DHPG at the same time because the bone marrow toxicity is made much more severe when the drugs are given together. This has resulted in the difficult decision as to whether to forgo potential life-extending therapy with AZT in order to preserve sight. An effective treatment for CMV retinitis is needed that will allow the patient to also take AZT. ACV is presently the drug of choice for severe herpes virus infections. It has been shown to be effective in suppressing severe CMV disease in patients who have received bone marrow transplants.
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
CMV retinitis is one of the most common opportunistic infections in patients with AIDS. DHPG is at present the only drug available for widespread compassionate use in the United States. Although most patients respond to treatment with DHPG, the medication does not cure the infection. Most patients will have a relapse and will require retreatment with DHPG. Because of the large relapse rate, most people treated for CMV retinitis are placed on continuous treatment with DHPG. There are two major problems associated with ongoing use of DHPG: 1) The development of a low white blood cell (WBC) count (leukopenia) which is a known side effect of the drug; and 2) the increased risk for leukopenia when DHPG is given together with AZT, the only antiviral drug currently available for the treatment of HIV infection. Therefore, patients cannot take both AZT and DHPG at the same time because the bone marrow toxicity is made much more severe when the drugs are given together. This has resulted in the difficult decision as to whether to forgo potential life-extending therapy with AZT in order to preserve sight. An effective treatment for CMV retinitis is needed that will allow the patient to also take AZT. ACV is presently the drug of choice for severe herpes virus infections. It has been shown to be effective in suppressing severe CMV disease in patients who have received bone marrow transplants.
Patients receive ACV intravenously and AZT orally for 12 weeks. Tolerance of the combined administration of ACV and AZT is monitored. AMENDED: AZT dose lowered and inclusion of concurrent medication expanded.
Study Type
Enrollment
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
Illinois
-
Chicago, Illinois, United States, 60611
- Northwestern Univ Med School
-
Chicago, Illinois, United States, 60612
- Rush Presbyterian - Saint Luke's Med Ctr
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria
Prior Medication:
Required:
- Patients must have successfully completed remission induction therapy with ganciclovir (minimum of 14 days of therapy) for acute cytomegalovirus (CMV) retinitis within the preceding 48 hours. Patients who show no evidence of progressive disease are considered to have met criteria for successful induction.
Amended to allow:
- Investigational triazoles.
- Human recombinant erythropoietin (Eprex).
- Other investigational non-antiviral therapies offered through treatment IND.
Patients must:
- Have HIV infection as determined by a commercially licensed ELISA test confirmed by a licensed Western blot
- Have salvageable vision (corrected acuity of 20/100 or better) in at least one eye.
- Be capable of signing an informed consent.
Exclusion Criteria
Co-existing Condition:
Patients with the following are excluded:
- Known or suspected allergy to one of the study medications.
- Inability to maintain adequate hydration status.
Concurrent Medication:
Excluded:
- Concurrent therapy with nephrotoxic agents.
- Systemic therapy for another opportunistic infection.
- Systemic prophylaxis for Pneumocystis carinii pneumonia (PCP).
- Probenecid.
- Patients are advised that validity of this trial may be jeopardized by use of other potentially antiviral or immunomodulating treatments.
Patients with the following are excluded:
- Known or suspected allergy to one of the study medications.
- Inability to maintain adequate hydration status.
Prior Medication:
Excluded within 2 weeks of study entry:
- Steroids.
- Cytotoxic or immunosuppressive drugs.
- Investigational agents. (Amended to now allow these.) Immunomodulatory drugs (except ganciclovir).
Prior Treatment:
Excluded within 2 weeks of study entry:
- Radiotherapy.
Risk Behavior:
Excluded:
- History of unreliable drug intake and inability to cooperate in the testing procedures. Unwilling or unable to give informed consent or unwilling to sign approved consent form.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Masking: None (Open Label)
Collaborators and Investigators
Investigators
- Study Chair: HA Kessler
- Study Chair: CA Benson
Publications and helpful links
Study record dates
Study Major Dates
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
- Virus Diseases
- Infections
- Eye Diseases
- Retinal Diseases
- DNA Virus Infections
- Herpesviridae Infections
- Eye Infections
- Eye Infections, Viral
- Cytomegalovirus Infections
- Retinitis
- Cytomegalovirus Retinitis
- Molecular Mechanisms of Pharmacological Action
- Anti-Infective Agents
- Antiviral Agents
- Reverse Transcriptase Inhibitors
- Nucleic Acid Synthesis Inhibitors
- Enzyme Inhibitors
- Anti-HIV Agents
- Anti-Retroviral Agents
- Antimetabolites
- Zidovudine
- Acyclovir
Other Study ID Numbers
- ACTG 070
- 11044 (Registry Identifier: DAIDS ES Registry Number)
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
Clinical Trials on HIV Infections
-
University of MinnesotaWithdrawnHIV Infections | HIV/AIDS | Hiv | AIDS | Aids/Hiv Problem | AIDS and InfectionsUnited States
-
University of California, San DiegoUniversity of California, Los Angeles; University of Southern California; California... and other collaboratorsCompleted
-
National Institute of Allergy and Infectious Diseases...Eunice Kennedy Shriver National Institute of Child Health and Human Development...CompletedHIV Infections | HIV SeronegativityUnited States, Puerto Rico
-
Erasmus Medical CenterCompletedHIV/AIDS | Opportunistic Infections, HIV RelatedNetherlands
-
RANDBienestar Human Services, Inc.Completed
-
Ukrainian Institute on Public Health PolicyCompleted
-
University of California, BerkeleyNational Institute of Mental Health (NIMH); Ministry of Health and Social Welfare...Completed
-
Ryerson UniversityCanadian Institutes of Health Research (CIHR); Simon Fraser University; University...Completed
-
University of California, San FranciscoNational Institutes of Health (NIH); ANOVA Health InstituteCompleted
-
McGill UniversityCanadian Institutes of Health Research (CIHR); Université du Québec a MontréalUnknown
Clinical Trials on Zidovudine
-
Glaxo WellcomeUnknownHIV InfectionsUnited States
-
Institut de Recherche pour le DeveloppementEunice Kennedy Shriver National Institute of Child Health and Human Development... and other collaboratorsCompletedHIV Infections | PregnancyThailand
-
Glaxo WellcomeCompleted
-
National Institute of Allergy and Infectious Diseases...Eunice Kennedy Shriver National Institute of Child Health and Human Development...Completed
-
Glaxo WellcomeCompleted
-
Glaxo WellcomeCompletedHIV Infections | LipodystrophyUnited States
-
Universidad Peruana Cayetano HerediaMerck Sharp & Dohme LLCCompletedHTLV-I Infections | Tropical Spastic ParaparesisPeru
-
University of Colorado, DenverNational Institute of Allergy and Infectious Diseases (NIAID); University of...Completed
-
ViiV HealthcareCompleted
-
National Institute of Allergy and Infectious Diseases...Eunice Kennedy Shriver National Institute of Child Health and Human Development...CompletedHIV InfectionsUnited States, Puerto Rico